Back to Health Wellness Center

Back to Health Wellness Center
1625 State Street
Santa Barbara, CA 93101
Phone: (805) 569-5000
Email: This e-mail address is being protected from spambots. You need JavaScript enabled to view it

Patient Intake Forms

Please print and complete your Chiropractic and Nutrition patient-forms before you come into the office.

Chiropractic

Intake Form
Brief Nutritional Questionnaire

Nutrition

Patient Symptom Survey

Directions

From the 101 freeway traveling north bound: Exit Arrellaga. Stay on Arrellaga for about six blocks untill you get to State Street. There is a light at State Street. Turn Left onto State and go one half block. There on the left you will see a beautiful Victorian house with a lawn out front and a sign on the lawn which says State Street Chiropractic. Park alongside the building, in the driveway or rear area. Street parking is good for 90 minutes.

From the 101 freeway traveling south bound: Exit Mission. Turn left, go under the freeway and head up about five blocks to State Street. Turn right onto State Street and go down about five blocks, just past the International Pancake House on the right, to 1625 State Street. You will see a beautiful Victorian house on the right with a lawn out front with a sign on it which says State Street Chiropractic. Park alongside the building, in the driveway or in the rear area. Street parking is good for 90 minutes.

---

Add this page to your favorite Social Bookmarking websites